Understanding internet gaming addiction among South Korean adolescents through photovoice

Highlights

• Internet gaming addiction is a serious problem for adolescents.

• However, the problem of adolescents' internet game addiction has not yet been fully explored.

• The aim of the present study is to explore internet gaming addiction among South Korean adolescents.

• Methods used for the study included interviews, focus groups and photovoice.

Abstract

Internet gaming addiction is a serious problem for some adolescents in South Korea, although it has not yet been fully explored. The present study aims to explore adolescents' motivations for internet games, how their lives are affected, how they perceive internet games, what they gained and lost, and how they made sense of internet gaming addiction. Interviews, focus groups, and photovoice with a sample of ten adolescents at risk of internet addiction were conducted. The participants reported serious symptoms of internet game addiction, which negatively affected their psychological health and self-identity. They also reported that they were aware of how internet games negatively affected their daily lives, academic performance, and family relationships worsened once they became addicted to internet games. However, they also perceived internet games as avenues for entertainment, stress relief, and peer bonding. Understanding adolescents' perceptions and meaning of internet gaming addiction can facilitate the development of effective psychosocial intervention programs, which can subsequently contribute to healthy coping strategies and positive adolescent development and identity.

Introduction

As a result of national high-speed internet infrastructure investment, South Korea emerged as an ‘internet country’ or ‘mobile game country’ and as a leader in the development of the gaming industry and gaming contents. South Korean teenagers spend a great deal of time playing internet games as part of their leisure activities. According to the Statistics Korea (2018), adolescents in South Korea, aged 13–24-years, spend most of their time during the weekdays and weekends playing computer games (68.3%), and internet searches (59.7%). Due to availability of smartphones, personal computers, and other mobile devises, internet gaming addiction is increasingly becoming a serious social concern (Choi, 2014; Kim & Baik, 2011; Kwon & Lee, 2000). A survey of elementary, middle, and high school students conducted by the Korean Creative Content Agency (2017) found that 0.7% were addicted to internet games, 1.9% developed internet addiction, 81.5% were average internet game users, and 16.0% held a positive perception of internet games. Although the rate of internet addiction is low, the rate of youth becoming addicted to internet games had increased from 1.18% in 2012 to 1.89% in 2017, which suggests that additional research is needed.

In South Korea, research on adolescent internet gaming addiction has been actively conducted since 2000 when internet games were found to be related to physical and psychosocial problems. Adolescent internet gaming addiction has attracted research interest among South Korean scholars of various disciplines, particularly quantitative research (Kim, 2001; Lee, 2003; Yoon, Kyung, Lee, & Lee, 2012). Earlier studies in South Korea had focused on the overall situation, factors, and outcomes of internet gaming addiction (Kim, 2001; Lee G.W., 2001; Lee, 2001a, Lee, 2001b; Lee, 2002). However, over the years, researchers also focused on factors associated with internet gaming addiction within multiple contexts (e.g., family relationships, school life; Bae, 2014; Choi & An, 2010; Jang, 2005; Ju and Jwa, 2011; Jung & Kwon, 2003; Lee, Hong, & Park, 2005). Although these quantitative studies have advanced our understanding of factors and outcomes of internet gaming addiction and internet addiction in general, it is unclear how adolescents make meaning of their experiences with internet games. To address this, the present study utilizes qualitative research methods to explore adolescents' meanings of internet game addiction and it may affect them. More specifically, this study examines adolescents' psychosocial problems associated with internet gaming addiction and contextual factors related to addiction through in-depth group interviews and visual representations.

Internet gaming addiction is recognized as a recent societal problem resulting from the advancement of internet technology and the changes in the gaming environment. In South Korea and in several countries, there are debates on the concept and diagnosis of internet game addiction. The American Psychological Association (APA, 2013) categorizes ‘Internet Gaming Disorder (IGD)’ in section III under the DSM-V (5th edition). DSM-V identifies people with internet gaming addiction as ‘“gamers” as those who play internet games compulsively, to the exclusion of other interests, and their persistent and recurrent online activities resulting in psychosocial impairment or distress. People with internet gaming addiction have compromised academic or job functioning because of the amount of time they spend playing. They experience symptoms of withdrawal when they are not playing internet games.’ The DSM-V postulates that the IGD's 9 diagnostic standards are limited in their application across various cultures, and the conceptualization of internet gaming addiction has not been fully agreed upon and is under constant discussion and debate (Griffiths et al., 2016; Kardefelt-Winther, 2015; Petry et al., 2014). It is uncertain whether internet gaming addiction is a similar problem as alcohol or drug addiction, whether it is a behavioral problem, or whether it should be classified as an addiction. Kuss (2013) reviewed recent empirical studies on Internet Gaming Disorder and concluded that there must be a comprehensive understanding of the various contextual factors associated with this disorder (i.e., unique traits, living conditions, gaming preference, cultural environment). The preliminary International Classification of Diseases (ICD)-11 discusses the subject of ‘gaming disorder’ and there is currently an on-going debate on whether internet gaming addiction should be classified as a disease.

Although there needs to be a consensus regarding the conceptual validity of ‘internet game addiction’, ‘internet gaming disorder’, and ‘problematic internet gaming’ in research, extant studies have conceptualized it as obsessive use of internet games, which results in decreased academic performance, withdrawal symptoms, psychosocial maladjustment, interpersonal problems, and somatic symptoms. This study refers to the abovementioned conceptualization of ‘internet gaming addiction’.

The internet game addiction among adolescents can be seen as being influenced by a combination of internal motivation, family relations, school life factors, and media. First, it seems that the internal motivation of an individual adolescent to be addicted to internet games is affected by mental health symptoms such as impulsivity, aggression, depression, low self – esteem, low self-control, and anxiety. Moreover, internet gaming addiction can be influenced by unstable relationships between adolescents and their parents, caregivers' parenting behaviors (over-protection or high expectation, controlling behavior, lack of parental attachment, lack of family cohesion), school maladjustment (e.g., bullying, school violence, sexual stress, and negative relations with teachers). Furthermore, the high level of internet use and the proliferation of the internet game market in South Korea can also make internet games more accessible, which can contribute to internet gaming addiction.

Internet gaming addiction can contribute to adverse health conditions, such as insomnia, headache, gastrointestinal symptoms, cardiovascular system, vision problems, wrist pain, and symptoms of attention deficit/hyperactivity disorder (Choi, 2014; Kwon, Kim, & Lee, 2005; Lam, 2014; Ministry of Cultural, Sports and Tourism, and Korea Creative Content Agency, 2014). Adolescents who are addicted to internet games are also likely to display depressive symptoms, anxiety, aggressive behavior, impulsivity, feeling of guilt, lethargy, and emotional problems (Cheung, Chan, Lui, Tsui, & Chan, 2018; Lee G. W, 2001; Lee, 2003; Kwon & Lee, 2005). According to Lee H.C. (2001b), adolescents with internet gaming addiction sometimes have difficulty distinguishing reality from virtual world (Lee G.W., 2001). If they discontinue the game, they are likely to experience withdrawal symptoms, along with anxiety, irritability, and delusion (Lee H.C., 2001a).

As studies have shown, adolescents who are addicted to internet games may develop negative relationship with their parents at home, and more specifically, lack of communication with their parents, as well as lack of secure attachment (Choi & An, 2010; Chang, 2014; Kim, 2012; Park & Moon, 2012; Yoon, 2011). In addition, relations with peers and teachers are also negative impacted by internet gaming addiction (Jung, Park, & Suh, 2014; Kim & Baik, 2011; Kwon & Lee, 2000). Although many adolescents form friendships through internet games, spending excessive amount of time on the internet can also be problematic. Moreover, internet gaming addiction has been found to be linked to poor school performance and difficulty in concentration (Lemmens, Valkenburg, & Peter, 2009; Shapira et al., 2003), as well as conflicts with teachers and negative attitude towards school. Other studies also found that internet gaming addiction is positively related to school violence, alcohol consumption, running away from home, and suicidal thoughts and behaviors. For instance, Yoon and Chae (2014) reported that adolescents who are addicted to internet games have difficulty distinguishing reality from fantasy and are likely to re-enact violent behaviors they had seen on the internet. Anderson and Dill (2000) also found that frequent exposure to internet games can increase aggressive behaviors, and Lee's (2001) study findings revealed that internet addiction is correlated with fighting and positive attitude towards violence. Given the negative impact of internet gaming addiction, an in-depth exploration of this phenomenon is important, which is a necessary first step towards development of positive adolescent identity (Suler, 2005).